TriSalus Life Sciences (NASDAQ:TLSI) reported third-quarter revenue growth of 11% but updated its full-year outlook as newly added sales territories took longer than expected to become productive.
The company also cited a faster-than-anticipated shift toward a liver cancer treatment technique involving small blood vessels that its existing TriNav device could not fully address. TriSalus received Food and Drug Administration clearance in September for TriNav Advance, a device designed for those vessels.
Revenue for the quarter ended September 30 was $12.9 million, up from $11.6 million a year earlier and $11.4 million in the second quarter. President and CEO Mary Szela said growth fell below the company’s expectations despite increasing adoption of TriNav.
Sales Expansion Takes Longer Than Expected
TriSalus updated its 2026 revenue guidance to $46 million to $48 million, representing growth of approximately 2% to 6% from 2025. The transcript did not specify the company’s previous guidance range.
Szela said the shortfall against the third-quarter plan was concentrated in expansion territories, where representatives are building relationships with interventional radiologists and introducing TriNav into established workflows. TriSalus more than doubled its commercial footprint in the first half of the year.
About eight territories were ramping more slowly, Szela said, adding that the company had misjudged how long the process would take. Those territories continued to grow sequentially, she said, and the company had seen virtually no turnover since putting the new organization in place.
Chief Financial Officer David Patience said the expansion territories represented roughly one-third of the field organization and accounted for the vast majority of the third-quarter shortfall. The shift toward super-selective Y90 procedures was a much smaller contributor, he said.
Szela said the number of accounts ordering TriNav increased by a double-digit percentage year over year, and September was the company’s strongest month of 2026 for both ordering accounts and total units sold. Patience said TriSalus was confident revenue would increase sequentially in the fourth quarter.
TriNav Advance and Reimbursement Changes
TriNav Advance extends the company’s pressure-enabled drug delivery technology to small distal vessels through a physician’s choice of microcatheter, Szela said. The company is preparing a limited market release to gather clinical and customer feedback ahead of a broader launch.
Chief Medical Officer Dr. Richard Marshall said physicians have increasingly used super-selective treatment to deliver high radiation doses to small tumors while limiting exposure to surrounding liver tissue. The technique can also involve multiple small treatments within a larger tumor, he said.
Szela said TriNav Advance can address the super-selective procedures the company previously could not fully serve. Patience said the fourth-quarter guidance does not include revenue from Advance; the company expects to provide more information about its launch plans on its fourth-quarter call.
Management also pointed to Medicare payment changes effective January 1, 2027. The Centers for Medicare & Medicaid Services raised the national payment for procedures billed under the Y90 mapping code C8004 to approximately $20,910 from approximately $11,874. The payment for C9797, a pressure-enabled drug delivery embolization procedure, will also rise to approximately $20,910 from approximately $18,729.
CMS also established a national rate of approximately $13,788 per procedure for G0577, the code for pressure-enabled drug delivery embolization in physician offices. Szela said the rate will replace pricing previously set by individual Medicare contractors and support the company’s planned 2027 launch in office-based labs.
Financial Results and Clinical Studies
Gross margin improved to 86% from 84% a year earlier, which Patience attributed to lower average TriNav unit costs and manufacturing improvements. Research and development expenses fell to $3.2 million from $5.7 million, primarily because nelitolimod clinical trial expenses did not recur.
Sales and marketing expenses rose to $10.7 million from $6.8 million as TriSalus invested in its expanded commercial organization, though they declined from $11.4 million in the second quarter. Adjusted EBITDA loss narrowed to approximately $4.7 million from $5.4 million a year earlier. The company ended the quarter with approximately $41 million in cash.
Szela said TriSalus has 11 active studies across 27 clinical sites, with more than 400 patients treated with TriNav. Its evidence program includes studies comparing TriNav with standard microcatheters in liver cancer treatment, as well as research intended to identify which patients benefit most and assess economic outcomes.
The company expects to initiate neuroendocrine tumor and hepatocellular carcinoma studies by year-end. It also expects to deliver consolidated data from three nelitolimod dose-escalation studies by year-end, while continuing to evaluate its broader pancreatic cancer strategy.
Patience said the company expects meaningful double-digit growth to return in 2027, supported by greater sales-team productivity, TriNav Advance and reimbursement changes. TriSalus plans to provide formal 2027 guidance on its fourth-quarter call.
About TriSalus Life Sciences (NASDAQ:TLSI)
TriSalus Life Sciences is an oncology-focused healthcare company developing technologies and therapies for patients with liver and pancreatic tumors. The company combines medical devices, drug-delivery systems and immunotherapy programs to address tumors that may be difficult to treat with conventional approaches. Its core technology is Pressure-Enabled Drug Delivery (PEDD), a platform designed to improve the delivery of therapeutic agents directly to tumors through the arterial blood supply. TriSalus offers interventional oncology devices, including the TriNav Infusion System, which is designed to support localized delivery of treatments while helping limit drug diversion away from the targeted tumor.
